But what if your child really does have a middle ear infection? Then he will get antibiotics, right?

Not necessarily.

Since most ear infections get better on their own, antibiotics are typically reserved for:

children under age 6 months with acute otitis media (typically ear pain and a bulging ear drum)

children who are at least 6 months with acute otitis media and severe signs or symptoms, including moderate or severe pain for at least 48 hours or a temperature of 102.2°F (39°C) or higher

children who are under 24 months with “double” ear infections – both ears are infected at the same time, even if they just have mild symptoms

For most other children, instead of having you start antibiotics right away, your pediatrician might have you wait for 48 hours – the observation option. You can then start the antibiotics if your child doesn’t get better after a period of watchful waiting for two or three days. Until then, an age-appropriate dose of Tylenol (acetaminophen) or Motrin (ibuprofen) can often help control pain or fever.

In addition to your pediatrician, a pediatric ENT specialist can be helpful if your child has persistent ear pain.

What to Know About Children with Earaches

While it is sometimes obvious to know what is going on when older kids complain of ear pain, it is important to understand that not every earache means an ear infection, and even when it does, it might not mean a prescription for an antibiotic.